If you've followed us for a while, you know I've been urging practices of all sizes to take their payer directory listings more seriously for years now. It's not that insurers shouldn't do a better job. It's just that (as someone who once owned a directory company) I know how hard it is to keep directories accurate, especially if it's not your core competency (like, when your actual job is providing health insurance). It's also something that requires effort on both sides to be done properly. There's just no way around this. The insurer can't be expected to know when anything changes on your side unless you inform them. And while insurers should do a better job of accurately publishing information you provide them, mistakes are inevitable. It's up to you to catch them and make sure they're fixed. And it's absolutely worth monitoring and correcting your listings! I can think of few marketing tasks that are more directly connected to attracting new patients. Patients want to know that you're (1) in their network (2) accepting new patients and (3) convenient to them before deciding to contact you. If you're not listed accurately in their health plan directory, you're basically turning them away at your door. More on the latest study showing directories just haven't gotten any easier to maintain: https://www.healthcaredive.com/news/inconsistent-physician-directories-no-surprises-act/645307/
Laurie's 2018 article for Phreesia's blog is one of their most popular posts. If you haven't seen it yet, here's a link to check it out. It includes time-tested ideas for dealing with the roller-coaster ride that is the transition from the busy-busy fall season to the slowdown in January, including: Identifying the patients who can benefit most from booking services they've postponed before the year ends Making sure staff are trained and confident they can explain the pros and cons of booking care before year end Deploying and taking full advantage of all the tech at your disposal that can make it easier for patients to pay Planning to make conscious use of downtime in the spring--whether by increasing patient visits through promotion, using the time for other important tasks you've put off, or both There's still time to make a plan to have your practice business's best fall/winter season yet. If you'd like to discuss more ways to do so--and how we can help--please get in touch!
If you are frustrated by how confused patients can be about their insurance, and by the conflicts this confusion often leads to (especially about patient balances), you have good reason. Insurance is provided by employers, who theoretically should be able to explain it (it's an important part of employee compensation, after all). And it's offered and managed by insurance companies, who set and enforce the terms. There seem to be several good ways, logical ways to get information about insurance rules. So why do many patients misunderstand how it works? A few things are obvious. One is that health insurance can be very complicated. (It is complicated for those of us who work with it every day, even.) And the training and information patients have access to from their employers and insurers is simply not clear or accessible enough for many patients and many situations. This gap shouldn't be your problem. But it ultimately becomes your problem, since you'll have to deal with patients' confusion and corresponding reluctance to pay. All of which is a long way of saying that helping patients understand how their insurance works may not be something you should have to do, but it is something you're better off doing. And the earlier in the relationship you start the education process, the better. The clearer patients are on their financial responsibility before they receive care, the less likely they will be surprised by a large balance they didn't expect to owe. There is an old saw in marketing about how you have to repeat a message seven to ten times before anyone really absorbs it. The seven to ten is not regarded as a scientific analysis by anyone. But the idea that you have to repeat things, usually more often than you expect, and ideally via different media, is well accepted. (There's a reason you see and hear advertising by the same companies in different places and via different channels.) To this end, we often suggest to medical practices that they have some explanatory material at the front desk that covers common insurance issues--things like what
A provocative headline got my attention recently. It proclaimed that patient portals are "largely unused." It caught my eye partly because it didn't sound all that plausible -- and because taking such a headline at face value could be unhealthy for your businesses, dear clients and friends of Capko & Morgan. I decided to dig into the matter. The article text actually mentioned that 37% of patients have recently used portals. Could the author actually believe that 37% utilization is trivial? That seemed to be what they were saying, yet it's hard to imagine they believe that. (Would a 37% decrease in salary leave one's pay "largely" unchanged?) Perhaps, you may be thinking, this was just a forgivable, inadvertent misuse of "largely." But I tend to think not. This type of exaggeration is just too common in modern media, even in our world of the business of healthcare. I tend to think the headline intended to sensationalize. Yet even if that wasn't the intention, it's still not a benign error, which is why I'm calling it out. Mischaracterizing portal adoption has a hidden cost Clients often tell us they've held back on technologies that could make their practices more efficient because they're concerned patients won't use them. But that thinking usually means practices miss out on significant benefits, since the tools they delay adopting (or forgo altogether) could make interaction easier for patients or make their practices more profitable (or both). This tendency to hesitate has been especially true for patient portals, and it's often very costly. Somewhere along the way, the idea took hold that portals aren't worthwhile unless nearly every patient uses them. But this is not true. It's not even close to true. If even a small percentage of patients regularly uses a portal, those patients will benefit -- and their physicians will save time, too. (And that's strictly on the clinical side. Portals have the potential for even more dramatic benefits on the payment and administration side, even when utilization is very low.) What's more, relative to other recent technologies, portal adoption is arguably not that
(c) Sheri Swailes - fotolia.com No-shows can be a huge drain on medical practice finances. Time that is booked but ultimately generates no revenue is a loss that comes right out of your bottom line. It’s similar to what airlines experience when they have an unsold seat – which is why airlines so often resort to overbooking, and some practices do, too. But if you've seen the negative media coverage about the impact of flight overbooking on passengers, you already know what a stressful gamble the double-booking “solution” is. It's all but impossible to predict which patients will fail to show up -- so you could end up with too many arriving at the same time. Even when overbooking helps reduce lost revenue, it can create other problems -- like long waits, rushed visits, and stressed out physicians -- that lead to unhappy patients and higher marketing costs. Practice managers and physicians often throw up their hands in frustration about how to deal with no-shows, especially if they’re already taking steps to remind patients, or perhaps even charging a no-show or late-cancel fee. There’s no doubt about it, trying to improve your practice no-show rate can be challenging. But there are a few ways to look at the problem that practices sometimes miss. Consider if any of these ideas might help you reduce the cost of no-shows to your bottom line. Reevaluate Your Appointment Slots Practices often have standard appointment slots that they haven’t reviewed in a while. We recently worked with a practice that had used only two slots for over a decade: 30 minutes for established patients and 45 minutes for new patients. When we looked at how long visits were actually taking, we found that more time was usually set aside for the visit than was necessary. Besides reducing the overall number of productive slots the practice had available, these over-long slots amplified the impact of any no-shows. Even a single no-show usually left a 45-minute hole in the middle of the schedule – ouch. By tweaking the timings just a bit (30 minutes for
In a typical medical office layout, there’s a front door that’s used by patients and a rear door (or staff entrance) for employees. Of course, this can be quite convenient, especially when connected to employee parking. But an interesting consequence of this configuration is that physicians and managers never experience the reception area from the patient’s perspective. Next time you head out of the office during the day, come back in through the front door. Have a seat in the reception area. Are the seats comfortable? Are there enough of them? Are they spaced appropriately or too close together? (Imagine yourself sitting next to a sneezing flu patient if you need helping deciding.) If there’s a television, is it audible, but not too loud? Are there recent magazines on hand, or raggedy old ones from last year? What does the front desk activity convey to people waiting? Do patients look impatient – like they’ve been waiting too long? If so, does anyone behind the front desk seem to notice? In our consulting engagements, we almost always have comments on how the reception area can be easily and inexpensively improved. But you don’t need consultants to figure this out. It’s easy to self-diagnose – and the upside on improving could be huge. Patients start deciding how they feel about the quality of the care they receive the moment they walk into the office. Even ill patients will feel better about their visit – and their experience in the exam room – when their first moments in your practice reassure them they’re in a welcoming, professional, and caring environment. Patients view their entire practice experience as their “care” – not just the 15 minutes they get with a clinician. An inviting reception area is a cost-effective way to reinforce your practice’s caring attitude – and get the patient visit off to a strong start.
Independent primary care and specialty practices alike worry about increasing competition from hospitals and integrated systems. It’s not uncommon to see hyped-up headlines pronouncing independent practices “doomed” and the consolidation trend “inevitable.” But the naysayers always conveniently overlook a big advantage independent practices have versus larger organizations: the personal touch. In consumer settings, small players often find ways to compete against giants – and win. Maybe your town has an auto mechanic who outshines the dealer shops, thanks to better prices and more convenient hours. Perhaps your neighborhood has a family hardware store that’s going strong in the shadow of a big-box store, thanks to expert staff and a unique range of products. Or, if your area’s like mine, maybe you’ve got weekend farmer’s markets selling fresh vegetables by the truckload, despite the supermarkets down the street. Of course, these are just a few examples – but you get the idea. “Little guys” can flourish – if they find ways to serve their customers their super-sized competition can’t easily match. Competing against bigger, deeper-pocketed opponents can be scary. But it’s easy to forget those competitors have weaknesses as well as strengths. In medicine, it’s hard for a large, bureaucratic organization to provide the personalized experience a smaller practice can. And in what setting could a personal touch be more valued than in healthcare? If you’re worried about a big player setting up camp in your backyard, start thinking about how you can attract and retain patients with better patient service. Take a seat in your own reception area – and think about how it can be upgraded. Start looking at metrics like wait times and overall visit length, and consider how you can improve them. Check online reviews for comments you can learn from, and do your own confidential surveys to give patients a chance to tell you what they value – and what needs work. You just might find that you practice won’t just survive – it will thrive.
Personalized, customized service has become the norm in our lives as consumers. We've come to expect even everyday items like coffee and sandwiches to made to our specific preferences. But when we're talking about the administrative side of the patient experience, customizing can seem like a much bigger deal. With so many other demands on our medical practice processes, is the idea of personalizing beyond our reach ... or even a little nuts? It may seem that way, but it doesn't have to be. The wonderful thing about offering more choices in how to do business with your practice is that so many of the options patients seek can be cost-saving for you. For example, studies have shown that consumers prefer to pay bills electronically over sending checks. The trend towards paying online, on-the-go, at any hour of the day has become so pervasive, many people don't keep stamps or even checks on hand. If you're not allowing your patients to exercise this preference, instead hoping they'll mail a check (or only taking credit card payments by phone or in person at the office), you're making it harder for patients to pay. That probably means you're getting paid more slowly -- and at higher cost to your practice. But what happens if you do offer patients the ability to receive statements electronically and make payments that way, too? When patients can pay electronically, it's easy for them to do it immediately -- even if they receive your bill at 10:00PM. They avoid the unpleasant feeling of being behind on their bills, and your staff avoids the more unpleasant task of calling them to collect. And you'll get paid faster -- at less expense, since staff won't have to spend time on the phone with the patient or stuff an envelope with a statement. Best of all, when you implement an option like a payment portal or automatic debit, your patients will thank you for it, even as they're paying you more promptly and reliably. Electronic patient payments are just one of several examples of technology-enabled services that conserve staff resources
Chronic problems at the front desk are a way of life for medical practices in most specialties, and it seems there to little effort resolve these problems. The painful reality is that the demands on the front office are often unrealistic. It’s unlikely that the staff can handle a high volume of inbound phones calls at the same time they are helping patients check in and out, updating patient information, collecting patient payments, scheduling follow-up appointments, and answering patients’ myriad questions – and do it all well. No wonder a recent MGMA survey reveals that the front office has the highest rate of staff turnover in the typical medical office! Front office staff is set up to fail These tasks all demand more attention and time than your front office staff have. Since there is never enough time to give any task the attention it requires, front office staff is set up to fail. There is never enough time to get the work done and give patients the service they expect and deserve. It’s time to get realistic about front office workflow Start by understanding the distribution of tasks in the front office. Instead of front staff being generalists that all do same thing, divide the work in a way that makes each of them an expert and gives them sufficient time to manage their workload. Study the job description(s) for members of the front office team and diagnose workflow. Include the team in the process of improving the function of the front office. Compare the written job descriptions to the actual tasks and responsibilities of the position. Probe staff to get their input about workflow and what happens during the work day that makes the job difficult and demanding. Map out the current workflow, identifying bottlenecks and what causes them. Seek to divide and group tasks sensibly. For example, doesn’t it make more sense for patient inbound calls to be taken away from the front desk, so the patients can be checked in and out without interruptions that irritate patients or allow patients to slip out the door without
(c) Barclays PLC* A few days ago, the ATM turned 50. The first ATM in the world debuted in London in 1967; we got our first one in the US in 1969. Wow! I bet that the ATM has been around longer than many of you reading this. It's hard to imagine a time when this technology wasn't on every street corner. Yet when the ATM was first introduced, it was slow to catch on. In fact, it took about 30 of those 50 years for the ATM to be used by 2/3 of consumers -- and even as recently as 2013, more than 10% of consumers still had yet to pick up the ATM habit. The ATM's slow-but-steady path to everyday use got me thinking about technology in the medical practice. Technologies to connect patients and practices, especially on the administrative side, have emerged at a fantastic pace in the past few years. But many practices we've worked with have hesitated to implement them, for fear that the majority of their patients won't use them. Some practices that have implemented, say, a patient portal or online scheduling, have been disappointed because only a portion of patients seem excited to use it. "Laurie," they say, "we tried that. Only 20% of our patients used it. It was a failure, so we abandoned it." But when the ATM was first introduced, the adoption rate was much slower even than a 10% or 20% utilization your practice might see on its new payment portal or online schedule. So why didn't the banks give up? After all, implementing an ATM network is a massive, risky, very costly undertaking. So why were the banks undeterred by their meager initial results? And what can we learn from it for our own technology initiatives? The key is to focus less on the people who don't try the technology, and more on the people who do. For every one of those few customers who used the ATM in those early days, the bank could declare a victory. The consumer who wanted to use an ATM
Recently, the check-in automation company Phreesia invited me to write an ebook on one of my favorite topics: the patient-centered practice. It's called "Beyond Five-Star Reviews: Why the Patient Experience Matters, and How to Improve It," and it's available free with registration -- just click on this link. The idea of being more patient-centered and creating a better patient experience attracts more controversy and confusion than it should. The bottom line is that being more patient-centered fits with clinical goals as well as business ones, because it may help patients become more engaged and more receptive to clinical advice. "Patient-centered" is not about chasing positive reviews, and it's not about being patient-led. It's about understanding the patient perspective and communicating that you do, while also maintaining your practice's clinical integrity and mission. And it's about focusing on administrative processes patients interact with every day that can make your practice more or less welcoming and convenient for patients. The ebook contains some ideas that any practice can implement to improve the patient experience. I hope you'll check it out -- download it here.
A new study from the University of Florida found that patients' rudeness towards their physicians can have a "devastating" impact on medical care. Patient rudeness may play a critical role in medical errors, which by some analyses are now the third leading cause of death in the US. The Florida researchers determined that patient rudeness causes more than 40% variability in hospital physician performance. (By contrast, poor judgment due to lack of sleep led to a 10-20% variance.) The reason for the huge variance is that despite intentions to 'shake it off,' experiencing rudeness disrupts cognition, even when physicians are determined to remain objective. The researchers found that key cognitive activities such as diagnosing, care planning, and communication are all affected -- and the effects last the entire day. The study suggests that patients need to understand the potential for rude behavior to undermine their care, even when clinicians try their best to be patient and understanding, and even when the rudeness is driven by understandable frustration. But I think the results are also a reminder to practices to try to limit patient frustrations in the first place. Doctors often bear the brunt of patient rudeness when aggravation and anxiety boil over, even though most of what bothers patients happens before they even see their physician. Because administrative issues are frequently the source of dissatisfaction, it's possible for practice staff to prevent or ameliorate many blow-ups. Doing so may help patients have more productive visits with their clinicians, while also helping to protect the practice's reputation and maintain a pleasant work environment for the entire team. If you're concerned about emotional patients disrupting your practice, here are a few ideas to consider: Evaluate, minimize your wait times. A long, unexpected wait in reception is a sure-fire source of patient frustration. When it happens in your practice, is it a rarity or SOP? If running significantly behind is an everyday occurrence your practice, consider a review of your scheduling processes, to come up with a schedule that is attainable. And make sure your front and back office staff are working together
This amusing television ad from Cigna is bound to attract a bit of attention from fans of Grey's Anatomy, Scrubs, House, ER, and MASH. It's cute. If you recognize any of these tv docs, you'll likely enjoy it. And it has a message that can help patients get more out of their insurance, and help your practice, too. The gist: we'll use our skills as fake doctors to urge you to go see real ones for preventive services. Nice recommendation. Preventive services give your practice a reason to reach out to patients -- a gentle way to remind them your practice cares, and to keep them engaged. And it's a great way to get more use out of the EHR your invested so much time and money in implementing. With the deductible reset just over one quarter away, if you're a primary care practice (or other practice that offers a qualifying preventive service), you might also think about booking annual check-ups in Q1 of 2017. If your practice is among the many that see a slowdown in Q1, your patients will appreciate being able to come in when it's less busy. And deductible-free visits are good for your cash flow and cash-strapped patients' wallets after the holidays.
I'm working on an ebook right now about medical practice staffing. More specifically, it's about how the instinct to cut staff, to be as leanly staffed as possible, can backfire*. There are dozens of little details that any practice can explore to improve profitability. These small changes can be made with much less risk than eliminating a job or cutting staff hours. And because they improve the profitability of your processes, they are a gift that keeps on giving, making your bottom line a little bit bigger every day. Here are just a few of the possibilities I explore in the ebook. Are you taking full advantage of these opportunities to improve your bottom line? Reduce no-shows: Take a quantitative look at your no-show rate. Are you tracking both true no-shows and last minute cancelled slots that can't be refilled? Audit your reminder process and results. Is your timing right? Experiment with reminding further ahead or closer to the appointment. Remind people using the technology they prefer. Capture email and cell info: Being able to reach people electronically opens the door to multiple efficiency improvements, including more effective reminders and better collections. And your patients that want to be emailed or texted, not called, will appreciate the option. Win-win! Train patients on portals: Too many practices make portal adoption a low priority, or abandon the effort altogether, because they find it hard to get patients engaged. It is hard! But it's still very worthwhile. As more patients use your portals, you have more ways to reach them for marketing. Portals make other key tasks more profitable, too. Notice I said "portals," plural? If you don't have the ability to collect payments through your EHR portal, investigate the option to set up a payment portal with your PMS vendor. Patients want to help themselves -- and they want to pay without having to write a check or find a stamp. They'll reward you by paying faster and more reliably. If you cut staff before checking out all the possibilities to improve your operations, you may not have the people you need
ZocDoc just published a compelling new article and infographic pulling data from a survey they recently conducted about patient behavior. The data put a quantitative face on what many of us have been observing anecdotally and reading in blog commentary online -- namely, that patients are increasingly reluctant to see their providers, and costs and scheduling challenges are a big part of why. One tidbit that jumped out at me, since preventive care is something I consider a win-win opportunity for practices and patients, is that 80% of patients surveyed were putting off preventive care. Some of the key reasons ZocDoc found were the inconvenience of keeping an appointment during work hours (in fact, more than 40% said they would likely cancel because work took priority) and the inconvenience of making an appointment in the first place. Preventive care should be increasingly valuable to patients as deductibles and co-pays have grown across all types of health plans. But many patients don't realize that this is usually a way they can take advantage of their coverage without cost-sharing. Many other studies have shown that patients are more confused than ever about their health plans; this puts the burden upon practices to fill in the information gap (but that also spells opportunity for practices that do so). Are you doing all you can to engage patients and encourage them to take advantage of their preventive care benefits? Some ideas to consider: Consider offering an early morning or early evening appointment option at least once per week -- or even occasional Saturday appointments Look into online scheduling to allow patients to book appointments without having to make a call during work hours Use EMR list tools (remember them from MU?) and your portal to reach out to patients who haven't had preventive services or are overdue Put information about what's included in preventive care -- and why it's important -- on your website
If you missed Laurie’s webinar, “Front Desk Collections: the New Linchpin of Profitability,” here’s how to watch it now
If you missed Laurie's webinar, "Front Desk Collections: the New Linchpin of Profitability" (sponsored by Wellero) -- one of her most popular webinars ever! -- you're still in luck. Sign up here and watch it whenever you like. This practical presentation hits on some ways you can immediately increase profitability while avoiding pitfalls that can erode your practice's financial health. Take a look (it's free to sign up), and, if you have questions or comments after watching, please don't hesitate to contact Laurie. [yks-mailchimp-list id="87d94b707e" submit_text="Submit"]
Would you believe that failure to collect consistently and adequately at the front desk can actually create a negative impression of your practice's patient service? And that skipping financial conversations to keep the focus on patient can actually backfire? Money conversations can be hard for all involved. And, when a practice staff is very focused on patient-centered service, it can seem counter-intuitive to emphasize financial details -- especially when patients are ill or injured. But, ironically, not being clear about financial terms and not collecting appropriately can actually cause your patients to feel worse about your practice than a conversation about money ever could. When you fail to collect adequately at the front desk, your patients will receive a bill -- and, if you are waiting for their insurance to pay its portion first, that bill may not even be mailed until a month or more after their visit. By that time, the patient may have forgotten all about the visit -- and never even considered they would owe a balance, especially if staff never mentioned that they would or provided an estimate. It's likely they've already allocated their monthly budget to other things. And maybe they're confused about the bill -- and now will spend time trying to figure it out, perhaps on hold with their health plan, or feeling they have to call your biller. All of this adds up to aggravation. And if they don't believe (or don't want to believe) they owe the money, they can become quite angry with your practice. Nobody likes unexpected bills. Properly estimating patient costs and alerting patients that they have financial responsibility for all or part of their service is one of the kindest things you can do for them -- and critical to maintaining a positive relationship. Learn more about front desk collections at my upcoming webinar on 9/23/14 (9AMPST/12PMEST) -- sponsored by Wellero and hosted by Physicians Practice. It's free! Register here.
On July 8th Medscape presented a thought provoking discussion with three primary care physicians titled “The Good and Bad of Patient Satisfaction Measures.” This fuels the ongoing debate of the value and scores as part of physicians’ payment for their patient services -- a subject of keen interest to me. In March 2012 the Archives of Medicine published a study conducted by Joshua Fenton, MD, MPH, and colleagues at the University of California, Davis. The study analyzed data from more than 50,000 adult patients, indicating the most satisfied patients were 12% more likely to be admitted to the hospital and their healthcare and prescription drug costs were 9% higher. One of the most interesting findings to the study’s readers was that the report revealed more than 26% of these patients were more likely to die. What a startling fact! One of the strengths of this study was its nationally representative sampling. The findings were derived from the assessment of satisfaction based on 5 measures from the well-known CAHPS survey, emergency department visits and inpatient admissions. The tension between patient satisfaction and patient outcomes and cost savings continues two years after the study was released. There is discussion about whether physicians motivated by payment structures based on patient satisfaction are influenced in the ordering of diagnostic studies typical treatment standards in order to keep patients happy. An article in appearing in Forbes on July 21, 2013; “Why rating doctors is bad for your health” by Kai Falkenberg discusses this issue. "THE MATH IS NOW SIMPLE FOR DOCTORS: More tests and stronger drugs equal more satisfied patients, and more satisfied patients equal more pay. The biggest loser: the patient, who may not receive appropriate." When physicians are pressured and financially incentivized to keep patients happy an ethical dilemma occurs and some physicians succumb to appeasing patients by ordering tests they might not otherwise order. Forbes reported that the South Carolina Medical Association asked its members whether they’d ever ordered a test they felt was inappropriate because of such pressures, and 55% of 131 respondents said yes. Nearly half said they’d improperly prescribed
In 2013 NCQA rolled out the Patient-Centered Specialty Practice, PCSP, Recognition Program to distinguish specialists that achieve specific marks with: Developing and maintaining referral agreements and care plans with primary practices; Providing superior access to care (including electronically) when patients need it; Tracking patients over time and across clinical encounters to ensure patient care needs are met; and Providing patient-centered care that includes the patient, and when appropriate, the family or caregivers, in planning and setting goals. The motivation behind the PCSP program began when reporting discrepancies were identified between referring physicians and the specialists they refer to. For example, referring doctors claimed that between 25 and 50% of time they were unaware if the patients they refer are actually seen by the specialists. Another discrepancy was the specialist claiming they sent consult reports 80% of the time, but the primary care physicians state they receive this information only 60% of the time. With the PCSPs intent on improving care coordination and communication between specialists and their primary care physician, managing chronic and acute conditions across continuum of care will be better accomplished. The PCSP program also evaluates medication management, test tracking and follow-up and information flow over care transitions. This recognition program is expected to result in a better patient experience and improved outcomes.
The Patient-Centered Medical Home is so much more than just a payment innovation -- it's an idea that appeals for clinical reasons to so many physicians and practice managers, who were already aiming to provide the higher level of care-coordination and patient engagement that is the foundation of the PCMH. But many small practices we work with have been nervous about the hurdles for certification -- is it too much for a solo or two-physician practice to take on? A recent AAFP blog post offers a wonderful idea for smaller practices daunted by the prospect of tackling the PCHM checklist on their own: form an informal network with other, like-minded practices in your area, and divvy up the research and learning. What a great solution -- and a great way to expand your connections with other professionals in your community. Read about it here.
The buzz about being patient-centered is not just hype, the patient-centered movement is very real and there is much to gain. The primary premise of the patient-centered movement is that by building stronger relationships with patients they will be healthier. Healthier patients mean a healthier population. A healthier population reduces healthcare expenses which have soared in the United States over the past few years. Reducing these expenses is a goal that health plans are increasingly willing to pay practices to help achieve. Understanding what it means to be patient-centered is a complex process as it intends to recognize patients in terms of their own social worlds. This means throughout the patients’ healthcare experience they should be respected, listened to, informed and involved in their care. It is believed that shared decision-making results in better compliance and reduces health risk factors. Focusing on individual patient’s needs an applying evidence-based medicine is meant to improve the healthcare population. Insurance companies, recognizing these factor,s are in the process of implementing financial incentives and bonus structures based on key elements that improve the delivery of health care and manage costs by reducing complications and emergency room visits, and by complying with best preventive practices. Your intentions to be more patient-centered can be reached by: Strengthening the patient clinical partnership; Promoting communication about things that mater to the patient; Helping patients know more about their health and healthcare needs; Facilitating patients’ and caregivers involvement in the patient’s care; and Setting metrics to measure improvement. Being patient-centered is rewarding for your practice in so many ways: happier patients, potential financial upside, and stronger relationships between providers and patients. All of these themes are discussed in greater depth in my and Cheryl Bisera’s new book: The Patient-Centered Payoff (click the link to see the book's page on Amazon).
This is certainly a reasonable question to ask considering the rapid-fire change, threats and unknown factors medical practices face due to the Affordable Care Act. But here are a few things you can do to deal with all of this. First, keep your eye on the ball. Don’t throw up your hands in frustration, but follow the news and the legislation that is likely to impact the way you practice medicine, your future stability and the care and service offered to your patients. Read everything you can and keep your cool. In other words, don’t throw your hands up in despair. Put the emotions aside and be prepared to respond. If you know what’s coming down the pike you can be practice-ready and take strategic actions rather than wait, feel the panic and be reactive, which typically leads to poor, costly decisions. Well thought out decisions will explore not only the potential threats, but the opportunities that are available to you and your colleagues without compromising your integrity or patient care and service. Next, look at the numbers. How well did your practice perform compared to prior year and compared to other practices in your specialty? Benchmarking will help you examine the trends so you can examine areas where performance was disappointing and seek ways to bolster them for next year. The numbers tell the story of past performance and give you an opportunity to set future goals that keep the practice stable and on financially solid ground. Don’t make squeezing cost a primary focus. Sure, it’s normal to focus on costs when reimbursement is tight and may get tighter, but in reality you can only squeeze costs so much. If you focus most of your efforts on costs you are likely to reduce quality and service. The highest expense for a medical practice is staffing, but the old saying: “You pay peanuts, you get monkeys” is true. Hire well – highly skilled and experienced people; respect them, pay them well and set high expectation goals and staff well help your organization to me more profitable. Physicians and managers can
Leadership sets the tone for the entire practice. Staff will model your commitment and follow your expectations. Much of the manager’s role focused on managing practice finances, maintaining practice viability, and keeping a highly motivated and efficient staff that is respectful and trustworthy. Add to the list a new yardstick that changes how physicians get paid based on a patient experience that improves compliance to result in better outcomes. Develop a plan and set up programs to help staff understand how the patient experience relates to both outcomes and practice finances. Show your commitment through continued communication and actions that reveal a consistent effort to improve the patient experience. Give staff the education and tools to succeed in delivery consistency in your customer service organization-wide. Coach staff to improve performance. Provide them with the support and encouragement with implementing essential changes on the road to being more patient-centered. Manage progress well. This means conducting a baseline patient satisfaction study based on key performance areas and periodic follow-up to be sure targeted areas of improvement results in satisfactory results. Set your goals for becoming a best practice. Be explicit in what you expect and intend to achieve. Honor each person’s contribution and celebrate successes that achieved along the way. Leaders have the ability to set the stage for success, instill a sense of pride and hope within the organization, and meet the challenges of strengthening the relationship between the clinical practice and the patients they serve. In the end, we seek to improve the health of our patients, enjoy the relationship we have with patients and be among the best.
I will be conducting a webinar called “Nothing but the Facts: Find out What Your Patients Really Think, hosted by Kareo, on January 15th, 2014. Physicians and staff typically focus on what’s clinically the matter with patients and how to make them better. No question this is paramount, but there’s more to the patient experience. It’s time to find out if you are really meeting the patient’s expectations. This webinar will talk about the importance of conducting patient surveys to get the real facts about your patients’ level of satisfaction. You will discover key factors that influence the patient experience, and why healthcare reform is making this a priority. You will discover the impact of patient satisfaction on the overall practice performance. You will learn the technical details involved with conducting surveys that tell you what your patients need from you, and how to get the most out of the feedback information you gain. You cannot assume how patients feel about your practice. Your patient service performance depends on getting facts and learning what it takes to be a best-practice when it comes to the patient experience.
Healthcare reform is placing the relationship between the patient and the medical practice front and center in hopes of improving compliance and clinical outcomes. It’s all about strengthening the relationship between patients, their physicians and the entire practice and making patients feel valued. Although physicians are working hard to strengthen their relationship with the patients, the staff seems to fall short. In 2013 Capko & Morgan conducted a patient satisfaction survey that spanned five metro areas of the U.S. It revealed staff is falling short on making patients feel valued by their practices. 37% of the respondents felt the staff performed only adequately in terms of making them feel valued and respected, another 7% rated staff poorly, and suggesting there is much room for improvement. So what can you do to get staff on board with providing a better patient experience? Talk about it. Help staff understand that they are a reflection of the practice to every patient. It is an important role and they hold the key to making patients feel valued. Build in accountability. Schedule a customer service planning meeting with staff to collectively set some performance standard dealing with staff-patient interaction. New Patients: Every employee is expected to honor new patients and making them feel comfortable Get rid of the sign-in sheet. Introduce yourself and make a statement that welcomes them or thanks them for choosing your practice. Don’t just hand patients a clip board, explain why you need them to provide information and let them know you appreciate their cooperation. Thank them when they are finished. When rooming the new patient give some information about her new physicians to provide important reassurance that she is in good hands. All patients: Greeted with a smile and by name within one minute of arrival for a visit Kept informed of expected wait time in reception room and exam room Before ending the conversation with a patient ask “Is there anything I can help you with?” On the phone Staff will identify themselves by name. Callers will not be kept on hold more than 30 seconds without further communication
As medical practice management consultants, we're naturally always looking for 'best practices' we can share with all of our clients. There is often a rub, though: what's 'best' for one practice (or one practice type) may not be right for everyone. When it comes to the best way to solve practice management problems, sometimes the only correct answer, as economists like to say, is 'it depends.' No-shows -- how to deal with them, how to minimize them -- are a great example of this sort of problem. I've been participating in a lively discussion on the subject on LinkedIn in the medical office managers group. The discussion was kicked off via a link to an article that seemed to have the definitive list of to-dos (and not-to-dos) to maximize show-rate -- except that the comments from participants in the group suggested it wasn't so simple. Example: "don't use postcards as reminders -- they're a waste of money and don't improve show rates." But, the data cited in the article pertained only to a residency-based family practice, and the study didn't provide any information about the wording of the reminders. But, other studies that weren't restricted to academic family practices showed otherwise, although the relative benefits of postcards versus other reminder methods were less clear. And other data show that multiple reminder types used together -- a combination of postal and SMS text, for example -- might deliver still better results. Given the lack of clear data on an issue like no-shows, you may need to try different approaches and aim to continuously improve your practice's performance. The answer to the problem of the right mix of reminders for your practice is likely to be "it depends" ... but, on what? The good news is, you can think through some of the possible factors that will influence reminder success pretty readily, since you already know a lot about your patient base. For example, you know something about the age of your patients. A practice with mostly older patients -- say, cardiology -- might find that postcards are still among the best
Physicians only need to peek at their ratings on sites like Yelp, Healthgrades and Vitals to realize the unfair truth: patients lump every aspect of their interactions with your practice into their view of your "care." Worse, at times it seems like their reviews give more weight to things like staff courtesy and billing hassles than to their clinical outcomes! The good news is, however, is that this also means that making people feel cared for is a team effort at your practice -- and that means that the burden doesn't fall entirely on the physicians' shoulders. The key, though, is to make sure the importance of patient service is understood by everyone on the team, and that everyone takes responsibility for it. Some steps in the right direction: Educate your staff about the importance of patient service, and reward them for their good work. Let them know that your practice's reputation depends on their contributions -- and that you value it! Invest in training if improvement is needed. Survey your patients. Learning what's on their minds -- before they vent on a social media site or medical directory -- will allow you to address issues before they become problems. And, some patients will perceive your service to be better simply because you took the time to ask their opinion. Strive for a personal touch. Medicine is becoming bigger and more impersonal -- and that trend is only worsening with consolidation. But, this spells opportunities for small practices to stand out! Be sure your clinical routines allow for a bit of personal interactions with patients -- even just stating the patient's name at the start of the encounter conveys a touch of caring. Bring in outside help. If you're not 100% sure of how patients view your service and care, an objective analysis can be very valuable. Contact us* if you're ready for a comprehensive, cost-effective service review and action plan. When it comes to patient service problems, and ounce of prevention is worth a pound of cure! *our San Francisco office works on patient service projects -- contact us via email at "info" at capko.com,
A recent New York Times article and follow-up blog post discuss the challenges patients have understanding medical bills, through the eyes of a consultant named Jean Poole who has made a career of deciphering (usually highly erroneous) medical bills and helping patients recoup incorrect charges or reduce their outstanding bills. Billing is so challenging for practices -- even though specialized staff are usually handling the task, they have to contend with constant changing rules, reluctance of some payers to address issues, and the myriad of payment schemes with varying patient responsibility. But imagine how it is for patients -- who don't have any specialized knowledge to help them deal with the strange language and calculations of their bills. Ms. Poole's service would seem to be a godsend for patients who find themselves unexpectedly owing thousands of dollars (as the article points out, patient out-of-pocket obligations and opaque hospital fee schedules can lead to big surprises). It's great that she offers this service, for sure -- but how frustrating that it's so needed. The frequency of errors and lack of transparency in insurance company documents to patients is a big source of difficulty for practices. When patients feel they've been incorrectly charged or can't understand their bills, it undermines the trust they have in their physicians and other care providers. When your practice provides services in conjunction with a hospital, their billing clarity and accuracy (or lack thereof) can rub off on your patient relationships. While you can't control how hospitals manage their side of billing, you can at least make sure you're communicating as clearly and directly as possible with patients about what your practice will bill and how much of that bill their payer has declared to be the patient's responsibility.
What if hotel billing were like medical billing? A funny-but-sad video by Costs of Care in partnership with Harvard Medical School and the University of Chicago explores the possibility in a tongue-in-cheek way (click "continue reading" to view the video). "Surprise" medical costs do more than just frustrate patients -- they hurt practices, too. By helping patients understand the costs of their care, practices can help patients make more informed decisions, plan better, and maintain a positive relationship with the practice. And, patients who are better informed and understand what they'll be charged are more likely to pay their bills.
Balancing work flow and eliminating troublesome bottlenecks in a busy medical practice are chronic problems, but if ignored they become a financial drain and compromise patient service. In fact, a decline in profits and patient gripes are often the things that alert the physician or manager that workflow problems have gotten out of hand. But what's the best approach to getting to the root of your problems and finding the best solution? Start with communication. Meet with staff and enlist their support in clearly identifying where the bottlenecks are, what is causing them and what are the most reasonable solutions to pursue. It is leaderships job to be sure staff feels important and comfortable enough to come to you when they have a problem and believe they will get your support. Analyze the processes. Look for where the errors occur and where there are unnecessary steps or duplication of tasks. Even better, are there steps that can be eliminated through technology that save time, reduce errors and improve outcome? Invest in staff. Errors often occur and go undetected when new staff is not properly trained and when existing staff does not get on-going training to stay at the top of their game. This can result in frustration, poor morale and compromised outcomes, as well as causing division among the troops. Everyone needs the support of management; beginning with training and ending with performance evaluation and getting the tools to enhance performance.